Summary Of Evidence

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Analysis of Evidence

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Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) is a non-invasive, non-contact imaging technique. SCODI produces high resolution, cross-sectional tomographic images of ocular structures and is used for the evaluation of anterior segment and posterior segment disease.

Posterior segment SCODI allows for earlier detection of optic nerve and retinal nerve fiber layer pathologic changes before there is visual field loss. When appropriately used in the management of the glaucoma patient or glaucoma suspect, therapy can be initiated before there is irreversible loss of vision. This imaging technology provides the capability to discriminate among patients with normal intraocular pressures who have glaucoma, patients with elevated intraocular pressure who have glaucoma, and patients with elevated intraocular pressure who do not have glaucoma. SCODI also permits high resolution assessment of the retinal and choroidal layers, the presence of thickening associated with retinal edema, and of macular thickness measurement. Vitreo-retinal and vitreo-papillary relationships are displayed permitting surgical planning and assessment.

Anterior segment SCODI is used in the evaluation and treatment planning of diseases affecting the cornea, iris, and other anterior chamber structures. The procedure also may be used to provide additional information during the planning and follow-up for corneal, iris, and cataract surgeries.


INDICATIONS OF COVERAGE:

Posterior Segment optical coherence tomography (OCT) is considered to be reasonable and necessary to:

• Diagnose and manage medically and surgically retinal and neuro-ophthalmic diseases which involve changes in the optic nerve, subretinal and intraretinal changes, vitreo-retinal relationships and changes in the nerve fiber layer.

• Diagnose early glaucoma and monitor glaucoma treatment

• Differentiate causes of other optic nerve disorders when a diagnosis is in doubt.

• Diagnose and manage the patient's condition when visual field results are insufficient; or when reliable visual field testing cannot be performed, due to visual, physical, mental, or age constraints.

• Differentiate when a discrepancy exists between the clinical appearance of the optic nerve and the visual fields

• Detect further loss of optic nerve or retinal nerve fiber layer changes in the presence of advanced optic nerve damage and advanced visual field loss

• Follow glaucoma suspects.

Anterior segment OCT is considered to be reasonable and necessary to:

• Evaluate narrow angle, suspected narrow angle, mixed narrow and open angle glaucoma, and angle recession as all determined by gonioscopy

• Determine the proper intraocular lens for a patient who has had prior refractive surgery and now requires cataract extraction

• Evaluate Iris tumor

• Evaluate corneal edema or opacity that precludes visualization or study of the anterior chamber

• Calculate lens power for cataract patients who have undergone prior refractive surgery. (Reimbursement will only be made for the cataract codes as long as additional documentation is available in the patient record of the prior refractive procedure. Reimbursement will not be made in addition to A-scan or IOL master.)

• Evaluate and plan treatment for patients with diseases affecting the cornea, iris, lens and other anterior segment structures.

• Provide additional information during the planning and follow-up for corneal, iris, cataract, glaucoma and other anterior segment surgeries.

LIMITATIONS OF COVERAGE:

• Absence of an indication

• Screening